摘要
目的：比较前路减压Zero-p椎间融合器与传统钛板联合cage融合内固定治疗脊髓型颈椎病的临床疗效。方法：回顾性分析我院2010年1月~2011年10月采用前路减压植骨融合内固定治疗的46例单节段脊髓型颈椎病患者的临床资料，其中使用Zero-p椎间融合器植骨融合内固定22例（A组，n=22），使用传统钛板联合cage植骨融合内固定24例（B组），两组患者年龄、性别比、术前JOA评分、手术节段分布均无统计学差异，比较两组患者术中出血量、手术时间、术后JOA评分及JOA改善率、融合率、吞咽困难发生率和邻近节段退变率。结果：A组手术时间为97.3min，术中出血量86.4ml；B组为103.5min、90.6ml，两组比较无统计学差异（P〉0.05）。A组1例术后发生吞咽困难，B组8例术后发生吞咽困难，两组吞咽困难发生率有统计学差异（P〈0.05）。A组术后随访12~31个月，平均21.5个月，B组术后随访13~32个月，平均22.1个月，两组随访时间无统计学差异（P〉0.05）；两组术后JOA评分与术前比较均有统计学差异（P〈0.01），A组JOA改善率为61%，B组为63%，两组比较无统计学差异（P〉0.05）。两组融合节段均获得骨性融合，A组44个邻近节段有4个节段椎间盘信号发生退变或退变级别加重，B组48个邻近节段有8个节段椎间盘信号发生退变或退变级别加重，两组融合率和邻近节段退变率均无统计学差异（P〉0.05）。结论：应用Zero-p椎间融合器和传统钛板联合cage植骨融合内固定治疗单节段脊髓型颈椎病均可取得较好的疗效，但应用Zero-p椎间融合器术后吞咽困难发生率较低。
Objectives： To compare the clinical effects between Zero-p and traditional titanium plate with cage in treating cervical spondylotic myelopathy. Methods： The clinical data of 46 patients with cervical spondylotic myelopathy who underwent anterior cervical discectomy and fusion（ACDF） by Zero-p implant（group A, n=22） or traditional titanium plate with cage（group B, n=24） between January 2010 and October 2011 were retrospectively analyzed. There was no statistical significance of the age, the gender, preoperative JOA scores, and the surgical level between two groups（P〉0.05）. The intraoperative blood loss, operation time, postoperative JOA scores and JOA recovery rate, fusion rate, dysphagia incidence and incidence of adjacent segment degeneration in both groups were measured and compared. Results： In group A： the operation time was 97.3min, and the intraoperative blood loss was 86.4ml; while in group B： the operation time was 103.5min, and the intraoperative blood loss was 90.6ml. There were no significant differences with respect to the operation time and intraoperative blood loss between two groups（P〉0.05）. 1 patient in group A and 8 in group B suffered from dysphagia after operation, which showed significant differece between two groups（P〈0.05）. The follow-up for group A was 12-31 months（mean, 21.5 months）, and 13-32 months（mean, 22.1 months） for group B, which showed no significant difference（P〉0.05）. The JOA scores improved significantly after operation in both groups（P〈0.01）, with the JOA improvement rate in group A and B of 60.9% and 62.6% respectively, which showed no statistical signficance between two groups（P〉0.05）. All surgical levels fused well after operation. Among the 44 adjacent levels in group A, 4 discs developed degeneration or progressive degeneration in MRI; among the 48 adjacent levels in group B, 8 discs developed degeneration or progressive degeneration, which showed no statistical signficance either for the fusion rate or adjacent level degeneration rate（P〉0.05）. Conclusions： Zero-p implant and traditional titanium plate with cage have similar effective treatments for single level cervical spondylotic myelopathy, while Zero-p implant has lower incidence of dysphagia.
出处
《中国脊柱脊髓杂志》
CSCD
北大核心
2013年第5期440-444,共5页
Chinese Journal of Spine and Spinal Cord
关键词
脊髓型颈椎病
椎间融合器
内固定
疗效
Cervical spondylotic myelopathy
Intervertebral fusion device
Internal fixation
Efficacy
